Issue: July 2013
July 05, 2013
2 min read

WHO convenes IHR Emergency Committee for MERS

Issue: July 2013
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WHO has convened an International Health Regulations Emergency Committee to evaluate the Middle Eastern Respiratory Syndrome coronavirus threat, according to Assistant Director-General Keiji Fukuda, MD, MPH.

“We are doing this because we want to be ready for any possible direction this virus could take,” Fukuda said during a press conference. “We don’t know what the future will bring, but we want to make sure we can move as quickly as possible when we do know.”

Keiji Fukuda, MD 

Keiji Fukuda

The committee will consist of a group of experts across several fields, including infectious diseases, virology, epidemiology and public health. They will assess available information, determine whether the situation is an international public concern and discuss whether WHO should make any temporary recommendations.

To date, there have been 80 cases of MERS coronavirus and 44 deaths*. There have been a steady number of cases in the past three months: 19 in April, 21 in May and 22 in June.

Some of the features of the virus are relatively clear, Fukuda said. For example, the virus can occur across all age ranges, but most infections are occurring in older people, particularly men, and among people with comorbidities. Sporadic infections in the community have been reported, and there has been limited person-to-person transmission, primarily in families and in health care facilities.

“Compared to the SARS outbreak a decade ago, there are many fewer health care workers that have been infected,” Fukuda said. “We don’t know the exact reason for that, but it may be that there are better infection control practices.”

Transmission of the virus has been limited and has not resulted in large community outbreaks. Fukuda also said that there have been travel-related cases in several European countries, but the infections have not become endemic in these areas.

However, it is unclear what has caused the sporadic cases not linked to person-to-person contact. Possibilities include an animal reservoir or a contaminated environment. Another key piece of missing information is whether there are people with mild infections and no symptoms.

“Having this information would help us understand the epidemiology,” Fukuda said. “Because of this lack of information, it makes it hard to look into the future. Right now, we can characterize it as a ‘patchwork’ of local infections; some are occurring sporadically and some are occurring through limited person-to-person transmission. It is not sweeping through communities like influenza does.”

Fukuda said that there are three possibilities in the future: the virus could die out and go away; the current pattern of ongoing cases could continue; or there could be a change in the transmission pattern leading to more outbreaks.

“All of these things are possible,” Fukuda said. “Right now, it’s simply guesswork.”

*Last updated on July 8.